Oh Those Naughty Knots
Steven McCune, Physical Therapist, Performance Enhancement Specialist
Procore Physical Therapy P.C.
Do you have an area on your body that aches and pains and seems just out of reach? Well join the many out there that feel your pain! These nasty naughty knots are a very common source of muscular pain.
Muscles are comprised of bands of fibers that are prone to becoming taught and eventually form knots. As a knot forms, muscle fibers become twisted and entangled just as a knot may form in a strand of sewing thread. Over time, the entangled fibers can become stuck together and form a type of scar tissue.
A knot or trigger point is an area of scar tissue within a muscle which causes degrees of pain, discomfort and dysfunction. To find relief, people resort to all types of remedies, from lying on golf balls to rubbing against door hooks.
A knot produces pain when compressed and may evoke a pattern of referred pain. This is generally known as a trigger point. Pressure applied to the knot may also provide some form of relief or release of the twisted muscle fibers. We all know the saying 'hurts so good.'
The onset of a knot or trigger point may be gradual or sudden. Trauma will cause a sudden knot, whereas fatigue, stress and poor posture will cause a gradual onset of the knot.
Muscles associated with trigger points become tense and painful. The pain we experience is caused by ischemia or the lack of blood and oxygen that flows through the muscles. This ischemia can branch to other areas around the trigger point and cause satellite trigger points to form.
This cycle will lead to growing areas of pain and dysfunction. The most common trigger point locations include the trapezius muscles which are muscles between your neck and shoulders, and other muscles that run on either side of the spine.
So what can we do to provide some relief or rid ourselves of these naughty knots?
Treatment for trigger points may vary but should include restoring muscles to their full stretching capacity. Trigger point injections, massage, and acupuncture or acupressure are also viable treatment options.
The goals of treatment should include reducing the density and thickness of the knot. This is done by using various forms of soft tissue mobilization, pressure point compressions, and myofascial release techniques. Restoring muscle flexibility through isolated stretching of the affected areas will help to decrease pain and begin to regain function.
Since common trigger point culprits include poor sitting and standing postures and poor body mechanics during work activities, it is important to learn good postures and the exercises that foster them.
Trigger points can be the source of significant and prolonged pain and dysfunction. The good news is that we have treatment methods to discipline those naughty knots and recapture a pain free life.